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New for your workforce: Guide to Understanding Health Insurance

A common refrain from Americans is that health insurance is too hard to understand.

More than 50% of American adults report that they don’t have a clear understanding of their health insurance. Confusion abounds because most people reach adulthood without a formal introduction to health insurance terms and concepts; it is often a benefit provided to people before they have ample education about how to use it. And few human resources teams have time to field every insurance question their employees may have or take time to explain how their health plan works.

Illiteracy about health insurance is costly to employees and to their employers. A recent Health Insurance Literacy Survey from healthcare.com found 26% of Americans report that not understanding their health insurance better caused them to have higher medical bills. Another study found that people who don’t understand their health insurance are more likely to make emergency department visits, have inpatient stays, experience higher mortality rates and be less compliant with their treatment regimens.

The urgency of intervention

Given these statistics, it becomes clear how important it is to provide your workforce with materials to explain basic insurance terms and concepts including how to navigate their care, how to find the information they need and what to expect from their health plan’s coverage.

At Arkansas Blue Cross and Blue Shield, we don’t want any members to feel overwhelmed and confused about their health plan, so we have developed a 30-page downloadable guide to help members understand how the health insurance you provide works. It’s the first in a series of health literacy materials that we plan to create for our members.

Topics covered in this guide include:

  • What is health insurance?
  • Why do you need health insurance?
  • How and where do you get health insurance?
  • When do you get health insurance?
  • What is a health insurance network?
  • How does health insurance work and how much does it cost?
  • What are the types of health plans?
  • How do you use your member ID card?
  • How does pharmacy work?
  • What is ancillary coverage?

The guide explains concepts such as premiums, copayments, deductibles, coinsurance, out-of-pocket maximums, Explanations of Benefits (EOBs) and health spending accounts (HSAs). We designed this guide to be simple to read and reference when members need to double-check their insurance understanding.

We’re here to help

Our guide covers the basic mechanisms of health insurance, but members will always have individual questions about their claims, coverage and payments, questions our customer service team is happy to answer. Understanding the terms the customer service representative may use can make a demonstrable difference in how clearly members can express what their issues are and, later, how well they feel their questions have been answered.

We recommend printing some copies for your human resources office, but you can also email the guide, available as a PDF, to each employee for them to bookmark and refer to anytime. You can also post the link prominently on your website or intranet for easy access. We hope you find this new resource for your workforce a helpful and powerful tool.

Download our Guide to Understanding Health Insurance here.